Opioids Methadone Mega Thread and FAQ

[suessmayr]

...methadone doesnt effect the mu receptors that other opiates such as oxy and heroin effect, these are responsible for that euphoric feeling. .

That's bullshit.

 

[Cane2theLeft]

^yep. Methadone is undeniably a mu opioid receptor full agonist such as oxy and heroin. Period.

I've recently started a Methadone Clinic, today was my 3rd day. This is a private treatment CMG clinic in FL.They started me at 20mgs and today I was able to go up 5mgs, this still does not cover all my withdrawals for 24 hours, I understand that Methadone does take some time to "build up" in your system.

The past 2 days I've used at night time when my dose starts to wear off, not that much, last night a 8mg dilly and 15mg roxi, should I inform that nurses at the clinic that i've used when my dose wears off because it does not cover me or will that just make them less willing to increase my dose because I'm not complying with the program? I'm supposed to see the Dr. for the first time tmw, he wasn't there for my induction he just called it in or something on the phone. Should I voice my problems to him or will it just be a physical exam and the dosing nurse is the one with real power... I understand not all clinics are the same, just looking for some guidence.

I know drug testing questions aren't really allowed, but I only want to know if most methadone clinics will kick you out for weed?

Individual methadone clinic policies will vary regarding positive urine screens. Just go and ask the patients if you're uncomfortable asking the clinic... but you could always call anonymously and ask.

Regarding the opioids... it'll vary, they may be very strict or they may just recommend you increase your methadone dose.

 

[darky185]

^yep. Methadone is undeniably a mu opioid receptor full agonist such as oxy and heroin. Period.




Individual methadone clinic policies will vary regarding positive urine screens. Just go and ask the patients if you're uncomfortable asking the clinic... but you could always call anonymously and ask.

Regarding the opioids... it'll vary, they may be very strict or they may just recommend you increase your methadone dose.

Thanks for the merge and the reply I guess I'll just got a little early tomorrow with some extra cigarettes and try and find some answers outside, met a crack dealer and his escort girlfriend there today but I didn't really want to ask them too many questions

I expected them to start me at 30mgs, and didn't allow me to go up any on day 2 and up to 25mgs on day 3, so it should be obvious I'm still using... That being said, hopefully after I see the doc tomorrow he can get me up at least another 10mg's, I'm not trying to go up to 80-120 but a nice 50 or 60 should take care of my sick and some of the cravings. I get a nice mood boost and some motivation for a few hours off the 20-25mg's as it is but nothing like a nice high.

getbarrled: Thanks, I've already been telling her that, I'm not lying to increase my dose to her it just doesn't nearly last me 24 hours.... gotten maybe 8 hours sleep total in the 3 days since I started. Good luck to you, I'm going to try and stick with it, at least for a little while and see where to go with it. Currently I have no idea how long I want to be on but right now my life needs some stabilization and normalcy and methadone seems like a nice option, I've already tried sub off the street for a few months but it wasn't for me.

 

[Cane2theLeft]

^you're getting on methadone for the right reasons if you're looking for a little stability and haven't been able to find that off of opioids altogether. If you really want to get out of the whole lifestyle, it'll take more than a methadone clinic but its certainly a good first step.

I definitely encourage you to keep us updated on how you're doing in the last link in my signature... its especially great to hear how people are doing going onto or off off maintenance medication and its a great place to talk to other people who have been there or are there now and get some support, ask some questions, etc.

 

[ThePharmicist]

Although I've only ever been on bupe I can answer your questions because I just saw my doc. to arrange a bupe-methadone switch and asked him those EXACT questions.

1) Methadone handles cravings better (I've heard/read this from dozens, no, hundreds of users) as it's a full agonist i.e., saturates your brain's receptors whereas bupe only sprinkles them with piss.

2) My doc told me today that it's absolutely possible to get off methadone with minimal - zero discomfort, provided you go extremely slowly. Now that I think of it, it's only ever been from people who went cold turkey that I've heard horrible things about methadone WD's.

I'm changing to methadone from bupe in a few days for that first reason precisely, namely, cravings. S.

I figured that as far as cravings go, methadone is your best bet if your looking to squash them. I kind of see methadone as a good choice for people who have really heavy habits. By that I mean people who are doing super short acting full agonists, ie heroin or large amounts of oxycodone, dilaudid etc. People who are addicted to taking a few hydrocodones everyday would be better off just using Suboxone - because methadone is a heavy drug itself.

And I figured that it was also possible to get off methadone with minimal discomfort - provided you're talking MILD withdrawal. Perhaps it's possible, but just not probable with the majority of MMT patients. Although we don't really know the statistics.

I'd still like to hear Cane2theLeft's opinion on this. I have a feeling that Suboxone works better at receptor down regulation because of it's agonist/antagonist properties, it's not self-reinforcing like a full-agonist.

Cane, could you chime in and let us know what you think about Suboxone vs Methadone tapers and if it's possible to feel little w/d with a slow methadone taper?

 

[suessmayr]

Wikipedia, for all its bullshit, does cite a study or two which would appear to confirm the proposition that "methadone withdrawal" is much worse than heroin withdrawal. But I imagine that the situation contemplated is one of cold-turkey withdrawal. If methadone was literally and in every instance at least "twice as bad" in the withdrawals (what those studies say) I don't imagine that it would be as effective or as strongly advocated as it has been.

S

 

[SubDude]

I'm changing to methadone from bupe in a few days for that first reason precisely, namely, cravings. S.

Have you been on subs for at least a year with clean Urines. If so please let me know if they allow weekly or bi-weekly takehomes after your MMT dose is stablized. I'm thinking seriously of going back to MMT but can't handle the clinic visits everyday for mos.

Wikipedia, for all its bullshit, does cite a study or two which would appear to confirm the proposition that "methadone withdrawal" is much worse than heroin withdrawal. But I imagine that the situation contemplated is one of cold-turkey withdrawal. If methadone was literally and in every instance at least "twice as bad" in the withdrawals (what those studies say) I don't imagine that it would be as effective or as strongly advocated as it has been.

I just saw my subs dr a few days ago and he told me the latest research on MMT is 80%+ relapse rate for those who quit or taper off.

 

[Cane2theLeft]

I'd still like to hear Cane2theLeft's opinion on this. I have a feeling that Suboxone works better at receptor down regulation because of it's agonist/antagonist properties, it's not self-reinforcing like a full-agonist.

Cane, could you chime in and let us know what you think about Suboxone vs Methadone tapers and if it's possible to feel little w/d with a slow methadone taper?

I have heard wildly varying anecdotal evidence about how people's opioid tolerance is affected by BMT. Some claim that their tolerance drops precipitously when they use BMT and others claim it didn't change for them at all. Assuming that tolerance will reflect receptor down-regulation, its difficult to extrapolate from this.

Methadone, especially with the ways its generally prescribed for maintenance, usually noticeably raises people's tolerance if it doesn't jack it up right thru the roof. This is part of the philosophy for MMT- it doesn't produce a receptor blockade such as suboxone so they put most people on doses of 80-120mg/day and this raises their tolerance and stays in their system so long that it makes it more difficult to get high on other full agonists.

Its certainly possible to successfully taper off methadone with little discomfort (people who have successfully tapered that I've talked to who were on long-term did 1mg/day reductions or even slower) but its probably more likely to induce mild withdrawal or general discomfort during the process than BMT.

The most common complaint I hear is that their doses don't hold them for the whole 24 hours during the process. Its not going to be ANYTHING comparable to full-blown withdrawals and if you supplement the taper with some clonidine or sedatives at night, it can be done relatively painlessly.

Wikipedia, for all its bullshit, does cite a study or two which would appear to confirm the proposition that "methadone withdrawal" is much worse than heroin withdrawal. But I imagine that the situation contemplated is one of cold-turkey withdrawal. If methadone was literally and in every instance at least "twice as bad" in the withdrawals (what those studies say) I don't imagine that it would be as effective or as strongly advocated as it has been.

S

Wikipedia was actually been found to be just as accurate as other encyclopedia's such as Encyclopedia Britannica by the renowned British journal 'The Lancet'. People assume that since anyone can edit it, it must be rife with misinformation. In reality, the process they implement to monitor submissions is rather effective. Anyway, on to your post...

"Worse" is a subjective term... methadone withdrawals never come close to reaching the intensity of that produced by short-acting full agonists such as heroin, morphine, fentanyl or oxycodone but they are protracted as fuck. Whether someone considers one or the other worse basically comes down to whether you prefer your misery to be quick and intense or more dull and drawn out.

 

[BlueLightBeam]

I was on a methadone clinic for 18 months. I have used many opiates, from oxycodone, oxycontin, heroin, fentanyl, to methadone (and everything inbetween.) The withdrawals of methadone are the worst. If there is any way for someone to avoid going on methadone maintenance, I'd advise them to take it. Going on the clinic was the worst decision I've made, as far as opiates are concerned. My dose was up to 220mg a day, and I was still getting "sick" 14 hours later. I went off the clinic by starting at 5 mg a day for 10 days, and then 5mg a week. It was disgusting.

 

[suessmayr]

Have you been on subs for at least a year with clean Urines. If so please let me know if they allow weekly or bi-weekly takehomes after your MMT dose is stablized. I'm thinking seriously of going back to MMT but can't handle the clinic visits everyday for mos.

I live in Australia and have already completed nearly 2 years without messing up on the subs, therefore I will be able to get 4 takeaways per week immediately after switching to methadone. My doc said that although this isn't a question strictly of laws, it is customary to limit bupe takeaways in most cases to one week's worth and methadone TA's to 3-4 days work. So I'm confident that before long he'll just give me a week in methadone. Also he said that if I ever wanted to travel, as with bupe, I can get 200 doses (or pills, I forget) of methadone at once.

How far is the drive to your clinic man? Is it really better to be on a less-than-ideal medicine that it would be to just hit up the clinic daily for methadone? Personally I find the daily visits can be helpful, as they make it more difficult to just lapse into inactivity and depression.

S

 

[SubDude]

I live in Australia and have already completed nearly 2 years without messing up on the subs, therefore I will be able to get 4 takeaways per week immediately after switching to methadone. My doc said that although this isn't a question strictly of laws, it is customary to limit bupe takeaways in most cases to one week's worth and methadone TA's to 3-4 days work. So I'm confident that before long he'll just give me a week in methadone. Also he said that if I ever wanted to travel, as with bupe, I can get 200 doses (or pills, I forget) of methadone at once.

How far is the drive to your clinic man? Is it really better to be on a less-than-ideal medicine that it would be to just hit up the clinic daily for methadone? Personally I find the daily visits can be helpful, as they make it more difficult to just lapse into inactivity and depression.

S

Thanks for your input.

I hope the usa is at least as open as Australia. Actually the closest MMT clinic is only a few miles away... I just can't seem to wrap my mind around getting up and going everyday... especially considering the observed UA's they require. I have kidney/bladder issues which make it extremely difficult to go when someones next to me [in a small room] and watching. I can't even piss in a public bathroom unless I use a stall. I used this clinic yrs ago and they're pretty strict about this... not to mention whether they will allow me to keep my k-pins for ptsd. I remember once trying to pee there [twice without success] and finally drinking so much water I was dancing around like a kid trying to keep from peeing my pants... while waiting for the observer to get back to me. it's just a tough choice considering all the factors including the extra $400+ cost.

I guess i'm just gonna need to make an appt with the clinic dr and see if they're willing to accomodate me in some way.... if I could just get weekly takehomes and keep the benzos... I'd give it a try.

 

[BlueLightBeam]

The clinic I was on wouldn't let you have a prescription for benzos over a certain amount. I think it was something like 1.5mg of Kpins max per day, but may have been 1mg. No xanax prescriptions allowed. Fail two drug tests in a row for benzos and you were put on detox. It's kind of silly, I failed every test for mairjuana, and half the tests for other opiates and they didn't care.

 

[suessmayr]

You're like the 4th person now I've heard complain about observed urines. To me it sounds fucken stupid - don't they know that it's difficult to piss on opiates? How can they honestly expect that of you? What a shame that you're not getting ideal treatment because someone insisted on watching you piss.

Man if I were you I'd make an appointment with a doc and go in and tell him you're thinking about switching but you're worried about not being about to piss, and about that being interpreted as some type of dishonesty.

S

 

[suessmayr]

Oh and I know how difficult it is, because I was once in hospital and on some type of opiate and had to piss under supervision and literally just COULD NOT do it, no matter how hard I tried. Thought something was wrong with me at the time lol.

S

 

[onlywant2nod]

I noticed back in August of 2010 that taking 100mg generic cvs sleep aid gelcaps(diphenhydramine) that it seemed to give me a nice buzz. Well long story short I got caught up in what would be a month of using them until I wound up in the er.

I dont know if its because I stopped taking them cold turkey or what, but 4 or 5 days after quitting them I was throwing up bad one day, so bad I couldn't even hold down water. Suddenly I thought to myself it might be wd's from stopping them. Well stupid me I told my family I was going to take just two of them and see if its just wd's, they took them from me before I could try.

I wound up in the er at 3am, they gave me some medication through my iv that I forgot the name of, plus 2mg dilaudid for the pain. I was surprised I got a nice buzz from it, seeing that I'm on 200mg methadone 1x daily and xanax 2mg 3x daily. I had gas pain from gas buildup and constipation so they did a catscan on me. I dont know why but when they shot that dye in me for the test, suddenly I felt even more buzzed.

I was in a hospital bed for only 2 days and became delusional because the dumb doctor who I didn't know was a psychiatrist, just ct took me off the xanax and just put me on 0.2mg clonopin for only a few days 2x daily. Long story short they put me on this antipsychotic crap, zombieprexa as I call it(Zyprexa). That crap made me a zombie and I was more delusional etc than when I made the mistake of going to the er.

I was finally released from that joint a night before thanksgiving, I instantly stopped the crap they were giving me and tore up the script for the crap I was prescribed and I didn't feel totally like myself again until we got home from my brothers house from thanksgiving and I resumed my normal xanax schedule when I got home. I know I did a real stupid thing to keep taking diphenhydramine as long as I did. Even more dumb, now 2 months later I started taking them again, but only for a few days because I am scared shitless of ending up in that mess again.

What I wonder is, could I have avoided the er if I had only not said something and just took the 2 sleep aids and tapered off them instead?
What caused me to go psychotic(nothing violent just me saying strange stuff)?
I think they caused me to feel worse at the "nut ward" by giving me meds I possibly didn't know I was even getting.
and lastly, for anyone else with experience in potentiating methadone with diphenhydramine. How long is a safe time to be on them? what is the highest dose in one night one can take?
what is the best way to stop before winding up like I was?

 

[suessmayr]

I don't think there's any withdrawal associated with diphenhydramine; isn't it an antihistamine? This is a methadone thread - probably not the right place for your post.

Hey guys - I was switched to methadone yesterday from my subs and feel SO SO SO much better already. I was brought down to 6mg of subs, then dosed one day on subutex, then yesterday began methadone at 40mg, today 50mg. How long do people find methadone takes to reach optimal levels? Also, after switching like this, how many days to people find it usually takes until the methadone is working ideally? I have no real idea about methadone dosing, except that doses like 250mg + are considered huge. My doctor said that there were only two people at my clinic above 120mg and that the Australian government is required to give permission to take any patient above 200mg. What are average doses?

Peace

S

 

[suessmayr]

 

[Ripamaru]

People normally level out around 80-100mg. I have never needed more than that but some people go way above.

It doesn't really seem to do anything more by going higher IMO.

It takes 4-5 days or so to reach optimum level in my body but everyone is a bit different and it depends on your metabolism.

I take 1 200mg cimetidine tablet 30-40 mins before I dose and it makes the done work better.


My advice though is to not go any higher on the methadone dose than you need to to feel decent. It is just more you have to drop down later IMO.....

 

[Ripamaru]

Tramadol won't do anything, especially if you have been on methadone.

Not in my experience.....

A year ago I had tapered down to 20mg a day of methadone and got cut off......

I decided to try to get off them and after almost a week of WD I was given some Ultram. I thought it wouldn't do shit but said what the hell and took 200mg along with my usual blunt.

I actually got some sleep and woke up not nearly as sick. I continued taking the tramedol for a week and a half until I could survive by just smoking weed.

I managed to be clean for a couple months before my dumb ass started using oxy's again and ended up back on done.....



Anyway, it helped me with the WD a lot......granted I had already cut down a lot and was committed at the time to quitting.....

 

[Alice_D]

yeah honestly I would just go on whatever dose you need when you are first getting off the opiates. Of course starting out around 30mgs and slowly working your way up, and then once you are stable try and go down a little bit. I hate to hear when people are on 180-200mg+ because I just think of the nightmare they will face trying to get off lengthy high doses like that.